Is There a Role for Laboratory Parameters in Predicting Coronary Artery Involvement in Kawasaki Disease?

Abstract

Background Kawasaki disease (KD) may cause cardiac and coronary complications. Since definite markers to accurately predict coronary involvement is not present, we aimed to analyze the role of hematological indices [neutrophil-to lymphocyte ratio (NLR), platelet-to lymphocyte ratio (PLR), lymphocyte-to monocyte ratio (LMR), and mean platelet volume (MPV)-to lymphocyte ratio (MPVLR)], prognostic nutritional index (PNI) and systemic immune-inflammation index (SII) in predicting coronary involvement of KD. Patients The medical records of 134 KD patients admitted between January 2008 and December 2019 were investigated. Also, 268 age-matched healthy controls (HCs) were included in the study.

Methods KD patients were divided into two groups: KD with coronary artery lesions (KD-CALs) and KD without CALs. Logistic regression analysis was performed to determine parameters that may predict coronary involvement in children with KD.

Results Among KD patients, 39 (29.1%) had CALs. When compared with HCs, the median levels of WBC, neutrophils, monocytes, eosinophils, platelets, MPV and, the values of NLR, PLR, MPVLR, SII were significantly higher; whereas lymphocyte count, PNI, platelet distribution width (PDW), LMR were markedly lower in the KD group (p˂0.001 for all, except for p=0.010 for eosinophil count). The CALs group's SII, PLR, and PNI values were significantly lower than those without (p=0.030, p=0.032, and p ˂0.001; respectively). Multivariable regression analysis revealed that PNI, SII, and gender (male) were associated with CALs in KD.

Conclusion Our analysis revealed that male sex, lower PNI, and lower SII levels were independently associated with CALs in children with KD.

Zusammenfassung

Hintergrund  Die Kawasaki-Krankheit (KD) kann kardiale und koronare Komplikationen verursachen. Da definitive Marker zur genauen Vorhersage einer koronaren Beteiligung nicht vorhanden sind, wollten wir die Rolle hämatologischer Indizes [Neutrophilen-zu-Lymphozyten-Ratio (NLR), Thrombozyten-zu-Lymphozyten-Ratio (TLR), Lymphozyten-zu-Monozyten-Ratio (LMR) und mittleres Thrombozytenvolumen (MPV)-zu-Lymphozyten-Ratio (MPVLR)], prognostischer Ernährungsindex (PNI) und systemischer Immunentzündungsindex (SII) bei der Vorhersage einer koronaren Beteiligung von KD analysieren.

Patienten Die Krankenakten von 134 KD-Patienten, die zwischen Januar 2008 und Dezember 2019 aufgenommen wurden, wurden untersucht. Außerdem wurden 268 altersangepasste gesunde Kontrollen in die Studie aufgenommen.

Methoden KD-Patienten wurden in zwei Gruppen eingeteilt: KD mit Koronararterien-Läsionen (CALs) und KD ohne CALs. Es wurde eine logistische Regressionsanalyse durchgeführt, um Parameter zu bestimmen, die eine koronare Beteiligung bei Kindern mit KD vorhersagen können.

Ergebnisse  Unter den KD-Patienten hatten 39 (29,1 %) Koronararterien-Läsionen. Verglichen mit gesunde Kontrollen, waren die Medianwerte von Leukozyten, Neutrophilen, Monozyten, Eosinophilen, Blutplättchen, MPV und die Werte von NLR, TLR, MPVLR, SII signifikant höher, während Lymphozytenzahl, PNI, Blutplättchenverteilungsbreite (PDW), LMR deutlich niedriger als in der KD-Gruppe (p=0,001 für alle, außer p=0,010 für die Eosinophilenzahl) waren. Die SII-, PLR- und PNI-Werte der CALs-Gruppe waren signifikant niedriger als die ohne (p=0,030, p=0,032 bzw. p ˂ 0,001). Eine multivariable Regressionsanalyse ergab, dass PNI, SII und Geschlecht (männlich) mit CALs bei KD assoziiert waren.

Schlussfolgerung Unsere Analyse ergab, dass männliches Geschlecht, niedrigere PNI- und niedrigere SII-Werte unabhängig voneinander mit CALs bei Kindern mit KD assoziiert waren.

Key words

coronary artery lesions - Kawasaki disease - prognostic nutritional index - systemic immune-inflammation index

Schlüsselwörter

Koronararterienläsionen - Kawasaki-Krankheit - prognostischer Ernährungsindex - systemischer Immunentzündungsindexpublished online 2022

Publikationsverlauf

Artikel online veröffentlicht:
04. Juli 2022

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